Massive downgrade of mileage (Read 1493 times)

So I've got my first marathon in 5 weeks, I've been training hard all winter, and around 2 weeks ago my leg started hurting. Not like a stabbing sudden pain, but a fairly strong, pretty constant ache on the inside (medial) of my right tibia. I still can't really figure it out - no swelling, though it's tender to touch the edge of the bone. Not muscular (I think) since I can do heel raises on stairs and to lifts with no pain. I tried to grind through it for a week, in case it was just my bones getting used to the new (6 months old) stress, but it didn't get better so I mostly shut down to 2 runs/week. I found it'd hurt when I started for the first couple miles then go away, then be murder around 20 mins after stopping. It didn't seem to be healing that way, so this week I've shut down totally. I did find that I can cycle though without pain, which makes me think that won't hinder recovery, so I can at least maintain fitness (or reduce rate of fitness loss, if nothing else)

Question 1 - anyone know what this might be?

Question 2 - my training was on pace to shoot for a really good time, sub-3:20. After the pain started, I ran a 28km (16-17mi) long run in an intentionally slow 2:30, so I think I can still run at 5min/km (~8min/mi?), which is right on for a 3:30 marathon finish. Anyone have any thoughts on whether this is slow enough? It's still ambitious obviously, but I'm ok with that.

Best-case is that I keep my fitness cycling and 2-3 weeks from now my leg is pain-free and I can start on some strides and light-ish mileage to make sure my legs are still under me on race day (May 27th)

I can't/won't Internet-diagnose, but a table in Daniels Running Formula that I just happened to look at last night said you'll lose very little of your fitness with two weeks of no running but a good amount of cross-training (i.e., cycling). Something like 1-2%. So don't stress about that aspect, anyway.

I'm not a doctor but I'll venture a (mis)diagnosis - stress fracture. You should get it ruled out out before you run a marathon.

As internet diagnoses go, this would be my best guess as well. But it is only a guess, and if you are worried about it you should see someone about it. If you are diagnosed with a stress fracture (or have an undiagnosed one!) running the marathon would not be the best idea.

If it is not a stress fracture, with good cross training you should not lose a ton of fitness. If you were legitimately in 3:20 shape when you had to cut back (not just ON TRACK to be in 3:20 shape on race day) then 3:30 would seem reasonable.

If you can bike and not hurt it, make sure you get some solid sustained efforts in. That will preserve your fitness more than just easy pedaling.

"If you want to be a bad a$s, then do what a bad a$s does. There's your pep talk for today. Go Run." -- Slo_Hand

To spaniel and kencamet: What made you think it is likely a stress fracture as opposed to just shin splint? (I'm not questioning your judgments, I actually do want to figure out how to tell them apart). Thanks.

To spaniel and kencamet: What made you think it is likely a stress fracture as opposed to just shin splint? (I'm not questioning your judgments, I actually do want to figure out how to tell them apart). Thanks.

The short answer is, without being checked out, one cannot tell so it is best to suggest the worse of the two possibilities be checked out. The OP was "training hard all winter", which reduces the likelihood that shin splints would come up now vs a stress fracture. The pain is on the inside of the leg vs facing forward, as would be more common with shin splints. Finally shin splints tend to be bilateral, though not necessarily so.

Also, it "hurts like murder" 20min afterward...I've had shin splints...I would not describe them that way.

So yes, it could be shin splints. But the above tidbits make me think it would be wise to definitively exclude stress fracture. I've seen people train through "shin splints" that turned out to be stress fractures, and end up having to take 3-4 months off as a result.

"If you want to be a bad a$s, then do what a bad a$s does. There's your pep talk for today. Go Run." -- Slo_Hand

Could also be a stress reaction. Basically that is the beginning stage of a stress fracture. The tibia is overwork (usually from too much intensity and not enough rest) and is flexing too much.

I had a bought of it at the end of Feb, beginning of March and took some time off. I tried to cross train to keep my fitness, but ended up losing alot of it. My run mileage right now is less then half what it was before the stress reaction, but my swim total is one good month from topping my YTD total for 2011.

The pain that hurts the worse is the imagined pain. One of the most difficult arts of racing is learning to ignore the imagined pain and just live with the present pain (which is always bearable.) - Jeff

Exactly what spaniel said plus the onset of the pain seemed to be sudden - not a gradual buildup (which is what I remember when I had shin splints when I first started running).

I don't know mooyootoo's running background but I assume he just started running (maybe a very bad assumption) because of his running log. If that's the case he's got some talent for running because he ran a 5K time trial (not a race!) in 18:39 in March off of 3 months of 20 - 40 miles/week. Took me years of much higher mileage to get down into that range. Not saying good or bad just saying, relative to my experience .... WOW. But I think it leaves open the possiblity of his musculo-skeletal system (tendons/ligaments/joints/bones) not being able to handle the paces he's done some of those workouts. As I understand it, It takes a while for the components in that system to adapt and rebuild itself to handle the stresses of fast-paced running.

In order to not derail what looks to be a promising runner, I would definitely get it checked out before I ran a marathon.

- no swelling, though it's tender to touch the edge of the bone. Not muscular (I think) since I can do heel raises on stairs and to lifts with no pain. I tried to grind through it for a week, in case it was just my bones getting used to the new (6 months old) stress, but it didn't get better so I mostly shut down to 2 runs/week. I found it'd hurt when I started for the first couple miles then go away, then be murder around 20 mins after stopping.

Disclaimer: See a sports doc and rule out a stress fracture.

When you say it's "tender to touch the edge of the bone" is it in one spot or is it along the length of the tibia? Is it diffuse or can you isolate one spot? From what I understand, if you had a stress fracture, the pain wouldn't ebb as you run, it would be constant. And you'd have one really painful spot on the tibia.

But sounds like a stress reaction, the precursor to a stress fracture. All sorts of other names for this including periostitis, MTSS or "shin splints". Been there, done that and it was exactly as you describe. Had an MRI that showed the periosteum had pulled away from the bone and inflamed and there was elevated bone metabolism. Next step would've been a stress fracture. Ice massage as often as you can. Get it checked. Keep your fitness up with non-impact stuff and see a sports doc before running the marathon. My stress reaction cost me three months a couple years ago. I was dumb and ran through it for too long and lengthened the recovery time.

I'm digesting the responses and I'm getting the idea that hard/fast pace training contributes more to shin splint/stress fracture than tons and tons of easy miles. Is that right or am I trying to read too much between the lines?

I'm digesting the responses and I'm getting the idea that hard/fast pace training contributes more to shin splint/stress fracture than tons and tons of easy miles. Is that right or am I trying to read too much between the lines?

It's an overuse injury. Either too many miles or too much intensity can be the culprit.

I'm digesting the responses and I'm getting the idea that hard/fast pace training contributes more to shin splint/stress fracture than tons and tons of easy miles. Is that right or am I trying to read too much between the lines?

I think fast-paced training before you are ready will get you shin splints faster than a roughly comparable volume of easy miles. I am not sure I would say that "tons of easy miles" will be better than a reasonable amount of fast training.

Basically, when you push your body past the point to which it has adapted, and do not allow adequate recovery, you risk things like shin splints.

Newer runners over-doing it tend to be over-doing it with harder workouts, not by doing a lot of easy miles, so some of the linkage between shin splints and hard work could erroneously be attributed to the hard work when it's really just a case of "too much of anything".

"If you want to be a bad a$s, then do what a bad a$s does. There's your pep talk for today. Go Run." -- Slo_Hand

Sorry to be the MIA OP, I thought this thread had died since I got no email notifications. Apparently I just neglected to subscribe to my own thread

Those guessing I'm a newb at this are correct, I have a soccer history, but this is the first time I've ever sustained this kind of volume and consistency in running (not much compared to many here, but still quite a lot for me for now). I think the overuse conclusion is a fair assessment , I came to the same one myself - it seems my muscles were more ready than my bones. I got nothing from the physician other than stay off it; the tender area is ~1/2 the length of the tibia so I guess not a fracture?

I've hardly run a step in the past almost 2 weeks, and while better its still there. Hopefully the fitness holds and I can still pull this off, though with 18 days to race morning I'm concerned, to say the least. I still intend to go toe the line and see what I can pull off, regardless, since I've registered and the bib is non refundable/transferrable